<style>
		.cus-layui-form-label{
		 text-align:left;
    	display: block;
   	 padding: 9px 15px;
    	font-weight: 400;
    	/*background-color: #d2d2d2;*/
    }

    .cus-layui-div img {
    margin-left: auto;
    margin-right:auto;
    display:block;
    }
	</style>
		<div style="margin: 15px;">
			<form class="layui-form" action="">
				<div class="row">
					<div class="col-sm-4">
						<label class="cus-layui-form-label" >提现用户:</label>
					</div>
					<div class="col-sm-8">
						<label class="cus-layui-form-label" id="name"></label>
						<input type="hidden" name="id" id="id"  />
						<input type="hidden" name="zcCount" id="zcCount"  />
					</div>
				</div>
				<div class="row">
					<div class="col-sm-4">
						<label class="cus-layui-form-label" >支付宝账户:</label>
					</div>
					<div class="col-sm-8">
						<label class="cus-layui-form-label" id="aliNo"></label>
					</div>
				</div>

				<div class="row">
					<div class="col-sm-4">
						<label class="cus-layui-form-label" >提现金额:</label>
					</div>
					<div class="col-sm-8">
						<label class="cus-layui-form-label" id="money"></label>
					</div>
				</div>


				<div class="row">
					<div class="col-sm-4">
						<label class="cus-layui-form-label" >备注:</label>
					</div>
					<div class="col-sm-8">
						<input type="notes" name="notes"  placeholder="请输入备注"  id="notes" class="layui-input" />
					</div>
				</div>

				<button lay-filter="suc" lay-submit style="display: none;"></button>
				<button lay-filter="fail" lay-submit style="display: none;"></button>
			</form>
		</div>
